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Bone Grafting and Barrier Membrane Consent

I understand that bone grafting and barrier membrane procedures include inherent risks such as, but not limited to, the following:

 

  1. Pain. Some discomfort is inherent in any oral-surgery procedure. Grafting with materials that do not have to be harvested from your body is less painful because it does not require a donor site surgery. If the necessary bone is taken from your chin or wisdom tooth area in the back of your mouth, there will be more pain. It can be largely controlled with pain medications. 

 

  1. Infection. No matter how carefully surgical sterility is maintained, it is possible, because of the existing nonsterile oral environment, for infections to occur postoperatively. At times, these may be of a serious nature. Should severe swelling occur, particularly accompanied by fever or malaise, professional attention should be sought as soon as possible. 

 

  1. Bleeding, bruising, or swelling. Some moderate bleeding may last several hours. If profuse, you must contact us as soon as possible. Some swelling is normal, but if severe, you should notify Swelling usually starts to subside after about 48 hours. Bruises may persist for a week or so.

 

  1. Loss of all or part of the graft. Success rates for bone and membrane grafting are high. Nevertheless, it is possible that the graft could fail. A block bone graft taken from somewhere else in your mouth may not adhere or could become infected. Despite meticulous surgery, particulate bone-graft material can migrate out of the surgery site and be lost. A membrane graft could start to dislodge; If so, the doctor should he notified. Your compliance is essential to ensure success.

 

  1. Types of graft material. Some bone graft and membrane materials commonly used are derived from human or other mammal sources. These grafts are thoroughly purified by different means to be free from contaminants. Signing this consent form gives your approval for the doctor to use such materials according to his knowledge and clinical judgment for your specific case. 

 

  1. Injury to nerves. This would include injuries causing numbness of the lips, tongue, any tissues of the mouth, and/or cheeks or face. This possible numbness may be of a temporary nature, lasting a few days, a few weeks, or a few months, or it could possibly be permanent, and could be the result of surgical procedures or anesthetic.

 

  1. Sinus involvement. In some cases, the root tips of the upper teeth lie in close proximity to the maxillary sinus. Occasionally, with extractions and/or grafting near the sinus, the sinus can become affected. If this happens, you will need to take special medications. Should sinus penetration occur, it may be necessary to later have the sinus surgically restored. 

 

  1. It is your responsibility to seek attention should any undue circumstances occur postoperatively, and you should diligently follow any preoperative and postoperative instructions.
Informed consent: As a patient, I have been given the opportunity to ask questions regarding the nature and purpose of the surgical treatment and have received answers to my satisfaction. I do voluntarily assume any and all possible risks, including the risk of harm, if any, which may be associated with any phase of this treatment in hopes of obtaining the desired results, which may or maynot be achieved. No guarantees or promises have been made to me concerning my recovery and results of the treatment to be rendered to me. The fee(s) for this service have been explained to me and are satisfactory. By signing this form, I am freely giving my consent to all and authorize Dr. Stephanie Miner and her associates to render any treatment necessary or advisable to my dental conditions, including any and all anestheticsand/or medications. 

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